消化系统恶性肿瘤术后早期活动安全危险性的文献分析  

Safety and Risk Evaluation of Early Ambulation after Gastrointestinal Malignancy Surgery:A Scoping Review

作　　者：刘婷婷 沈玲[2] LIU Tingting;SHEN Lin(School of Nursing,Shanghai Jiao Tong University,Shanghai 200025,China;Department of General Surgery,Xinhua Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200092)

机构地区：[1]上海交通大学护理学院,上海200025 [2]上海交通大学医学院附属新华医院普外科,上海200092

出　　处：《解放军护理杂志》2019年第6期52-55,共4页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的探讨外消化系统恶性肿瘤术后早期活动的安全性及危险因素,为临床护理实践和开展相关研究提供参考。方法以“胃肠、肝、胆囊、胰腺、结直肠”及“早期活动、下床活动、离床活动”为中文关键词检索中国生物医学文献数据库、万方、中国期刊全文数据库、维普等中文数据库;以“gastr*、intestin*、colo*、rect*、liver、hepat*、gallbladder、pancreat*”及“early ambulation、early mobilization、out-bed movement、postoperative ambulation、accelerated ambulation”为英文关键词检索Pubmed、Ovid、Em-base、Web of Science、EBSCO、CINAHL和Cochrane Library数据库等。检索时间为建库至2018年8月,重点提取术后首次下床活动时间、安全问题和危险因素等数据。结果共纳入17篇文献,纳入研究中术后早期活动的安全问题主要有伤口疼痛、晕厥或跌倒、直立性低血压或直立不耐受等,危险因素可概括为患者相关和医源性相关的危险因素。结论早期活动可能有利于降低消化道恶性肿瘤术后并发症的发生风险,但尚存在潜在的安全问题,临床实践中需及时评估危险因素,并加强早期活动的安全性管理。Objective To conduct a review on safety issues and risk factors of early ambulation in postoperative gas trointestinal cancer patients, in order to provide the references for clinical nursing practice and further research. Methods Chinese biomedical literature database,Wanfang,Chinese Journal Full-text database,VIP and other Chinese databases were retrieved by using “gastrointestinal,liver,gallbladder,pancreas,colon and rectum” and “early activity, out-of-bed activity and leaving bed activity” as Chinese keywords.Pubmed,Ovid,Em-base,Web of Science,EBSCO,CINAHL and Cochrane Library databases were retrieved with “gastr*,intestin*,colo*,rect*,liver,hepat*,gallbladder,pancreat*” and “early ambulation, early mobilization,out-bed movement,postoperative ambulation,accelerated ambulation” as English keywords.The retrieval time was from the establishment of the database to August 2018.The data of the first time out-of-bed activity,safety problems and risk factors were extracted. Results A total of 17 literatures were included,the safety issues included incision pain, syncope and orthostatic hypotension,et al.Risk fac tors were classified into patient-related and iatrogenic factors. Conclusions Early ambulation can possibly reduce the risk of postoperative complications,but there are still potential safety issues.In clinical practice,risk factors should be evaluated timely and the safety management of early ambulation should be strengthened.

关 键 词：消化道恶性肿瘤 早期活动 安全危险性 

分 类 号：R473.72[医药卫生—护理学]